32 year old female presented with enlarged metastatic bilateral neck nodes. A complementary simultaneous PET / MRI of the whole body was done following PET-CTto look for the possible primary and metastasis elsewhere in the body.
Coronal STIR(A) and PET/MR fused (B) image reveals metabolically active bilateral neck nodes
Axial STIR(A) and PET/MR fused (B) image reveals metabolically active altered intensity thickening in the right posterolateral wall of the nasopharynx (arrow) and an active subcentimeter right lateral retropharyngeal node.
Axial STIR(A) and PET/MR fused (B) image reveals a marrow lesion in the left lateral mass of atlas vertebra showing mild FDG uptake (arrow).
Corresponding axial CT images do not reveal any discernable nasopharyngeal lesion (A) or bony lesion (B).
Coronal STIR MRI (A) and Fused PET and MRI image (B) reveals the involvement of the pterygoid plate also indicate possible perineural intracranial extension.
Whole-body Fused PET and STIR MRI images show no metastasis in the remaining body.
MRI supersedes CT in delineating lesions better owing to its high soft-tissue contrast, detect marrow lesions much better (with or without cortical involvement), and can detect unsuspected perineural intracranial extension. Note: CT on the other hand, is less sensitive for detecting marrow lesions in the bone till the cortex is involved.
In this case, an apparent T2N2 disease was upstaged to T3N2M1 due to the superior information from the PET/MR which also altered the prognostication of the disease.
This short PET-MRI Scan case was compiled by Dr. Sangeeta Taneja and Dr. Amarnath Jena (Nuclear Medicine Physician at PET-Suite @ Indraprastha Apollo Hospital, Sarita Vihar).
Read More about PET-MRI Scan at House Of Diagnostics in Delhi and NCR.
The Simultaneous PET-MRI Scan is currently offered at PET-Suite at Apollo Hospital, Sarita Vihar.